Business and Marketing: How to do it... Managing falls

Acknowledging that all falls cannot be prevented, experts push for better management of fall risks. One source estimates that each fall costs about $19,000 in extra care. A facility can save mightily – in dollars, liability risks and morale – if its staff thoroughly pursues a sound falls management program. Taking the long view, one expert noted that "a little bit of money spent on safety is better than a lot of money spent after a fall."

1 Proper assessment and then supervision are critical for any falls management program. "Most falls occur because the faller's mind overrides the body's capabilities. The fall-risk resident, for any of a wide variety of reasons, attempts a simple physical task that she or he is likely incapable of completing safely – such as exiting a bed, or walking to the bathroom," notes Kit Sprague, marketing director for Bed-Check Corp., Tulsa, OK.
Assessment is essential to initially and periodically determine who is a fall risk. Many assessment tools are available, including a tool kit from the National Center for Patient Safety at www.va.gov/ncps/SafetyTopics/fallstoolkit/index.html.
Sprague calls it "a marvelous and unbiased resource."

2 Standardized criteria must be used during fall-risk assessments, points out Rob Nelson, product marketing manager, RF Technologies Inc., Brookfield, WI. Also, staff should be taught how to recognize risks and risk changes in residents, Nelson added.
The right type of monitoring, or supervision, then becomes critical.
"Bed and chair alarms should turn on automatically when the resident's weight is applied to the pad and alarm with a clear and distinct tone to alert caregivers that a resident is getting out of a bed or chair unassisted," Nelson said.

3 Family members also are vital. "Early communication with a resident's family regarding fall prevention is extremely important. One way to accomplish this is to hold an educational session at your facility," says Gregg Dohmen, fall prevention product manager, Direct Supply Equipment, Milwaukee, WI.
Providers should address the following topics with residents' families and staff:
• Falls that are unpreventable.
• Precautions your facility takes to prevent falls.
• Products your facility puts in place to protect residents if a fall does occur.

4 Once a system is up and running, it is important to assess its findings, points out Joe Whitt, vice president of sales and marketing for HomeFree Systems, Milwaukee.
"Look at technology that gives you data that will track patterns or events so you can interact before the fall occurs," advises Whitt. "Events that are day-to-day consistent, such as getting up in the evening at a certain time – if this occurs, there has to be a reason for it. Use the data to try to manage those events."

5 Loud or flashy alarms in or around resident rooms have fallen out of favor in recent years. Instead, electronic messages can be routed to nurses directly – and back to residents themselves. Voiced messages and prompts are becoming more common, especially with residents who are upset or speak another language, says Raleigh Ormerod, marketing director, Stanley Security Solutions Inc., Lincoln, NE.
He recommends using a "non-latching" feature when using a bed or chair pad.
"The system alarms, but offers the opportunity for the patient to self- correct the alarm by sitting back down, which resets the alarm," he explained.

6 Caregivers should look for root causes. In other words, examining why a resident might want to move from a certain place or at a certain time should be helpful.
"In many cases, a person tries to get out of a chair because he's uncomfortable," explains Geoff Lee, sales manager for CAREFOAM, Kitchener, Ontario. The firm offers a line of resident-care products.
"I'm not sure everyone in long-term care would agree that discomfort is one of the reasons people try to get out of a chair, but I suggest sitting in a geri-chair for six to eight hours yourself. They are not comfortable."

Mistakes to avoid, Don't forget to:

-Identify individuals at risk for falls by completing a comprehensive fall risk assessment

-Review medications for interactions

-Perform an environment assessment and make changes to reduce safety risks

-Assess, treat and manage the health problems known to increase fall risk

About 60,000 elderly or disabled Medicaid recipients in Louisiana are being told they should expect to lose their benefits in July, and advocates say more than a quarter of them could be forced out of the long-term care facilities they call home.